Ask An Expert / School

My son has made great progress in day treatment and is ready to return to a regular school. How can we get the school to work with him if he still has occasional outbursts?

Your son needs a school team that will be proactive about helping him behave

Mandi Silverman, PsyD, MBA
Mandi Silverman, PsyD, MBA

Clinical Psychologist, ADHD and Behavior Disorders Center

Child Mind Institute

My 10 year old son has been diagnosed with depression, anxiety, ADHD and is on the autism spectrum. He has been in a day treatment program for 2.5 years after being kicked out of his regular school. He is on meds and has made a lot of progress, however he still has occasional outbursts of violence. The day treatment program and we agree that his regular school would be a better environment for him now as he is getting triggered by some of the behaviors of the other children at day treatment. But the staff at the regular school doesn't seem to have any willingness or ability to help him succeed unless by some miracle he will act perfectly there all of the time. What do we do? Do we need to look at a different school environment? And if so, what? We've done so many things to try to understand his outbursts and help him to see violence is not the right choice. We are just at a loss here.

It sounds like you are doing an excellent job at making sure your son’s mental health needs are met.It also sounds like your son has made considerable progress in increasing his self-regulation and that is something to be applauded!

I think that as you consider returning him to his regular school, it would be important for you to meet with the school’s student support services team, which typically consists of school counselors, special education and regular education teachers, a school psychologist, a speech and language pathologist, and sometimes even school administration. By having a team meeting, you can express your current concerns for your son and his behavior and hear from the team how they plan to address his needs. In this way, you can be a part of the collaboration process in his educational planning for the year.

When thinking about behavior intervention, it is always important to emphasize a proactive and preventive approach, to increase positive behaviors and to take the focus off of the more negative ones. One specific suggestion I have for the difficulties you described above is to make sure that your son is informed of this change in settings well before he is set to go to his new school. You should be mindful of using positive language that celebrates his progress and his increased ability to return to a regular school setting. Also, you may want to schedule a time when he can take a tour of the school, meet his teachers and special area teachers, and maybe even have lunch in the cafeteria with same-aged peers. If you can have him ride the school bus, as a test run, that would be helpful, too. In this way, your son can mentally prepare for how things are going to look, feel, sound, and even smell (since we know that children with ASDs often have sensory sensitivities).

You’re right to think that what would help your son is a school where his teachers would take a proactive approach to his behavior—not just punish him if he fails. We use what we call the “A-B-C’s of Behavior.” “A” stands for “antecedent” (or trigger), “B” is for “behavior,” and “C” is for “consequence” (or result). If your son has a tantrum, you want to try to notice what happened immediately before it.. Did he want to get the person’s attention but didn’t know how to verbally do so? Was he upset by something that happened, but could not express why or how? Was he asked to engage in a difficult task that he wanted to escape from?

The last question is an important one because it highlights the concept of the function of a behavior. For example, sometimes children engage in tantrums when they want to escape something or obtain access to something that is rewarding. By noticing when your son seeks to escape a demand, this will allow his teachers to know what tasks are most difficult for him and where he needs the most support, as a means to prevent tantrum behavior. Additionally, by noticing when your son seeks to gain access to a desired object, this will also allow his teachers to know what he likes and how giving him access to it could help motivate him to engage in positive behaviors.

You can also encourage your son’s teachers to promote what we call the “positive opposite” of the behavior. For example, if they want him to have a calm body and relaxed voice, instead of saying, “Stop that!” give a positive replacement for something they do want him to do. In this example they can encourage him to have a calm body, or have a “safe body.” If they try this, we always encourage teachers (and parents) to give lots of specific praise following a positive opposite behavior. This would be something like, “Thank you so much for having a safe body! I like seeing when you’re calm.” This lets your son know that they like his behavior and they specifically like when he is calm.

Such positive feedback is especially useful for children on the autism spectrum as it is short, specific, and concrete, which is easily digestible and understandable for them. Additionally, when this feedback is given when you’re “catching him being good,” or when he is calm, your son is better able to take in that information and use it in the future to continue to engage in good self-regulation. A reward chart can also be an additional incentive for your son, if the stars or points seem really valuable to him.

Should you find that these interventions are difficult to apply or if you still feel like the school is not working with him, you can enlist the help of a mental health professional to consult with your son’s school or look for another school that is more open to giving him the support he needs.